Information for "the Genealogical Tree of the Wajszczuk Family"
1. My last and first name(s): .....................................................................................................................................................
Date (year) of birth:...................................................................................................................................................
Place of birth:.............................................................................................................................................................
Place of residence:.....................................................................................................................................................
(Profession, if you wish to disclose):.....................................................................................................................
2. Father - name(s).......................................................................................................................................................................
Year and place of birth:............................................................................................................................................
Place of residence:...................................................................................... Deceased, year: .................................
Mother - name and maiden name:...........................................................................................................................
Year and place of birth:.............................................................................. Deceased, year: .................................
3. Grandfather - name(s): ..........................................................................................................................................................
Year and place of birth:.............................................................................................................................................
Place of residence:...................................................................................... Deceased, year: .................................
Grandmother- name andmaiden name:..................................................................................................................
Year and place of birth: ............................................................................. Deceased, year: .................................
4. Great-grandfather - name(s): ..............................................................................................................................................
Year and place of birth:.............................................................................................................................................
Place of residence: .................................................................................... Deceased, year: .................................
Great-grandmother- name and maiden name:......................................................................................................
Year and place of birth: ............................................................................. Deceased, year: .................................
5. Great-great-grandfather - name(s): ....................................................................................................................................
Year and place of birth: ............................................................................................................................................
Place of residence: ..................................................................................... Deceased, year: .................................
Great-great-grandmother -name and maiden name:...........................................................................................
Year and place of birth: ............................................................................. Deceased, year: .................................
6. Wife (husband) - name(s), (maiden name): ........................................................................................................................
Year (and place) of birth ..........................................................................................................................................
7. Children:
1 name, year and place of birth:...............................................................................................................................
2 name, year and place of birth:...............................................................................................................................
3 name, year and place of birth:...............................................................................................................................
4 name, year and place of birth:...............................................................................................................................
5 name, year and place of birth:...............................................................................................................................
8. Sisters and brothers (according to age) - name(s), year and place of birth and place of residence:
1. ..................................................................................................................................................................................
2. ..................................................................................................................................................................................
3. ..................................................................................................................................................................................
4. ..................................................................................................................................................................................
5. ..................................................................................................................................................................................
9. Uncles and aunts (according to age) - name(s), year and place of birth and place of residence:
1. ..................................................................................................................................................................................
2. ..................................................................................................................................................................................
3. ..................................................................................................................................................................................
4. ..................................................................................................................................................................................
5. ..................................................................................................................................................................................
Attention: We would very much appreciate your prompt return of this form, even if the information is incomplete - so we can start processing immediately - (to be completed at a later date)!
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